A decade of homelessness: Thousands in S.F. remain in crisis

Ten years ago, San Francisco launched an ambitious effort to end chronic homelessness. Today and Sunday, The Chronicle looks at the city's limited successes and many failures at moving people off the streets.

Residents at the Mission Hotel often hang out in front during the day. Ten years ago San Francisco officials decided that supportive housing for the homeless was the only solution. Although many formerly homeless are now housed, few have had the training, schooling or support to actually get off the streets during the day.

Photo: Brant Ward, The Chronicle

Residents at the Mission Hotel often hang out in front during the...

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homeless127_bw.jpg The Ten Year Homeless Plan was unveiled Wednesday at City Hall. Mayor Gavin Newsom pointed out the great contributions of chairperson Angela Alioto, clapping, in bringing together a diverse group of San Franciscans trying to find new solutions to an old problem.BRANT WARD / The ChronicleRan on: 07-01-2004Ran on: 07-01-2004San Francisco Mayor Gavin Newsom and homelessness task force chairwoman Angela Alioto (clapping) announce the 10-year plan.

newsomhomeless006_ward.jpg The mayor made a tour of hotels catering to the homeless in the Tenderloin area, often stopping and talking with homeless along the way...he filled out a survey as he walked for this homeless woman, Elizabeth Jasoni-Gardipe...part of the massive outreach program by city workers.During 2004, Mayor Gavin Newsom of San Francisco went into the streets to talk with the homeless, even counseling some during a walk in the Tenderloin area. Ran on: 12-05-2004Mayor Gavin Newsom helps fill out a survey for Elizabeth Jasoni-Gardipe (on crutches), who is homeless, as he takes a walking tour of hotels catering to the homeless in the Tenderloin. The first-term mayor and his staff are upbeat about ending San Francisco's reputation as the city with the nation's worst homelessness problem.Ran on: 12-05-2004Mayor Gavin Newsom helps fill out a survey for Elizabeth Jasoni-Gardipe (on crutches), who is homeless, as he takes a walking tour of hotels catering to the homeless in the Tenderloin. The first-term mayor and his staff are upbeat about ending San Francisco's reputation as the city with the nation's worst homelessness problem.

newsomhomeless006_ward.jpg The mayor made a tour of hotels catering...

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georgia147.jpg As the San Francisco Giants salute Project Homeless Connect (a homeless services gathering), Georgia is joined by Mayor Gavin Newsom. She will throw out the first pitch, she has become a kind of postergirl for homeless in San Francisco.Georgia Mitchell, a homeless woman, has lived on San Francisco streets for years. In the last few years a medical condition with her knee finally forced her to seek treatment. Through a series of life events she has gotten medical treatment, and gotten permanent housing. It has been a long process costing the city of San Francisco over a quarter of a million dollars.{Brant Ward/The Chronicle} 7/31/06 Ran on: 10-29-2006For years, Georgia Mitchell could be found on the streets of the Tenderloin. When health problems finally sent her to a hospital, she required months of care at public expense.Ran on: 10-29-2006For years, Georgia Mitchell could be found on the streets of the Tenderloin. When health problems finally sent her to a hospital, she required months of care at public expense.

Gwendolyn Westbrook, the Director of the United Council of Human Services ( Mother Brown's) meets SF Mayor Ed Lee with her granddaughter, Jaiyah Gordon, 8, to give him a tour of the facilities. San Francisco Mayor Ed Lee met with the staff at Mother Brown's Dining Room program, a homeless drop-in center and soup kitchen on Jennings Street, on Tuesday, March 15, 2011, in San Francisco, Calif. The program is one that faces having its funding severly cut as the city tries to close a $380 million budget deficit.

Photo: Carlos Avila Gonzalez, The Chronicle

Gwendolyn Westbrook, the Director of the United Council of Human...

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A homeless encampment near the large city shelter on Fifth Street in San Francisco, Calif. recently suffered a tragedy when a homeless man was killed by a drunk driver.

A homeless man sleeps in the late afternoon after returning to his encampment near a San Francisco, Calif. off ramp. It has been ten years since the original Care Not Cash program was adopted in San Francisco, Calif. Although thousands have been housed, the streets are still full of homeless people.

A homeless encampment near a freeway off ramp that people only use in the evenings. In San Francisco, Calif. it has been ten years since the Care Not Cash program was initiated and to end chronic homelessness but the results have not been as hoped.

Danny, a homeless man suffering with a bad infection on Montgomery Street, watches people pass during the lunch hour in San Francisco, Calif. It has been ten years since the original Care Not Cash program was adopted in San Francisco, Calif. Although thousands have been housed, the streets are still full of homeless people.

Lisa and her two year old daughter panhandle off Montgomery Street in San Francisco, Calif. It has been ten years since the original Care Not Cash program was adopted in San Francisco, Calif. Although thousands have been housed, the streets are still full of homeless people.

Angela Alioto watches a homeless person feed her dog in the Tenderloin. Ten years after the Care Not Cash program in San Francisco, Calif. went into effect, Angela Alioto reflects on the progress to end homelessness.

Angela Alioto (right) stops to say hello to an old friend, Skinny Charles Thomas Moore in the United Nations plaza. Ten years after the Care Not Cash program in San Francisco, Calif. went into effect, Angela Alioto reflects on the progress to end homelessness.

Angela Alioto walks through the area between City Hall and the United Nations plaza. Ten years after the Care Not Cash program in San Francisco, Calif. went into effect, Angela Alioto reflects on the progress to end homelessness.

A homeless man brushes his teeth after waking near City Hall. In San Francisco, Calif. it has been ten years since the Care Not Cash program was initiated and to end chronic homelessness but the results have not been as hoped.

On weekends and holidays, the homeless gather under the eve of the Bill Graham auditorium near the Civic Center. In San Francisco, Calif. it has been ten years since the Care Not Cash program was initiated and to end chronic homelessness but the results have not been as hoped.

Hungry and homeless people gathered for a meal at the "Curry Without Worry" stand within view of San Francisco's City Hall Tuesday June 10, 2014. In San Francisco, Calif. it has been ten years since the Care Not Cash program was initiated and to end chronic homelessness but the results have not been as hoped.

Bus shelters in San Francisco can often contain people sleeping at all hours. In San Francisco, Calif. it has been ten years since the Care Not Cash program was initiated and to end chronic homelessness but the results have not been as hoped.

A chair left on a sidewalk provides some comfort for two homeless men on Eddy Street. In San Francisco, Calif. it has been ten years since the Care Not Cash program was initiated and to end chronic homelessness but the results have not been as hoped.

Members of the Hot Team, a group of homeless outreach professionals, approach a man suspected of being homeless near AT&T park. In San Francisco, Calif. it has been ten years since the Care Not Cash program was initiated and to end chronic homelessness but the results have not been as hoped.

Harold (left), a longtime homeless man, wakes in the morning with other homeless outside a motel on Mission Street. In San Francisco, Calif. it has been ten years since the Care Not Cash program was initiated and to end chronic homelessness but the results have not been as hoped.

A man holds his nose as he passes a person with a walker passed out near Fifth and Market Streets. In San Francisco, Calif. it has been ten years since the Care Not Cash program was initiated and to end chronic homelessness but the results have not been as hoped.

A man holds his nose as he passes a person with a walker passed out...

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Cathy, a homeless woman, sits with her husband Lance in the Gubbio Project at Saint Boniface Church. Later Cathy and Lance got a room in a Tenderloin hotel. In San Francisco, Calif. it has been ten years since the Care Not Cash program was initiated and to end chronic homelessness but the results have not been as hoped.

Two women hug near the long line for lunch at Saint Anthony's on Golden Gate Avenue. In San Francisco, Calif. it has been ten years since the Care Not Cash program was initiated and to end chronic homelessness but the results have not been as hoped.

A homeless man sleeps beneath his cart on South Van Ness Avenue in San Francisco, Calif. It has been ten years since the original Care Not Cash program was adopted in San Francisco, Calif. Although thousands have been housed, the streets are still full of homeless people.

Near the Powell Street BART station, a group of homeless men find some shade in San Francisco, Calif. It has been ten years since the original Care Not Cash program was adopted in San Francisco, Calif. Although thousands have been housed, the streets are still full of homeless people.

Dave, a homeless man for ten years in San Francisco, pushed his cart past the Bill Graham auditorium Tuesday June 10, 2014. In San Francisco, Calif. it has been ten years since the Care Not Cash program was initiated and to end chronic homelessness but the results have not been as hoped.

Phyllis Trammell, in pink hat, and her developmentally disabled son Louis Williams, right, wait in line with others hoping to get into the St. Vincent de Paul shelter in San Francisco, CA, Thursday, January 23, 2014. Phyllis and her son Louis have recently become homeless after losing their hotel in Sacramento and have been living on the streets of San Francisco for the last three weeks.

Photo: Michael Short, The Chronicle

Phyllis Trammell, in pink hat, and her developmentally disabled son...

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Romeo, a homeless man, has relied on the shelter at the Hospitality House for weeks. The Hospitality House men's shelter on Leavenworth Street in San Francisco, Calif. is the oldest facility serving the homeless with 25 beds and about five portable mattresses.

Romeo, a homeless man, has relied on the shelter at the Hospitality...

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James Bergen, a resident of the Mission Hotel, sits in his supportive housing room with his sister and talks about a stabbing he suffered. Ten years ago San Francisco officials decided that supportive housing for the homeless was the only solution. Although many formerly homeless are now housed, few have had the training, schooling or support to actually get off the streets during the day.

Photo: Brant Ward, The Chronicle

James Bergen, a resident of the Mission Hotel, sits in his...

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Jennifer Friedenbach, left, the director of the Coalition on Homelessness, confers with Bob Offer-Westort, the human rights organizer for the Coalition on Homelessness, during a board of supervisors meeting in San Francisco, Calif., Monday, January 23, 2012, to protest changes to two plazas in the Castro.

In 10 years, he pledged on June 30, 2004, the worst of San Francisco's homeless problem would be gone.

The most seriously ill homeless people would be moved indoors, clearing downtown streets of in-your-face transients who were startling residents and tourists alike. Emergency shelters would cease to exist because nobody would need them, he said. And new arrivals to the streets would be helped immediately.

"This is a dramatic shift," Newsom announced as he unveiled his "Ten Year Plan to Abolish Chronic Homelessness." "This won't all happen tomorrow. But it will get done."

San Franciscans are still waiting.

A decade and roughly $1.5 billion later, the city has succeeded in moving 19,500 homeless people off its streets, roughly equivalent to relocating the entire Castro district. But despite that major effort, the homeless population hasn't budged, showing that as one homeless person is helped, another takes his place.

In addition, Newsom left City Hall for Sacramento and has had no success pushing his pet issue as a statewide cause. His replacement, Ed Lee, has shifted the city's focus away from homelessness and onto job creation and tech promotion.

Meanwhile, new homeless encampments dot downtown alleys. Panhandlers still pervade the city. Needles, urine and human feces still litter sidewalks. It's not unusual to see homeless mothers with children begging downtown, people bathing in the sinks at the Main Library, and open-air crack and heroin use within view of the mayor's balcony at City Hall.

The homeless population is up 3 percent since 2005 - and that doesn't include a new count of 914 unaccompanied children and youths who don't have anywhere to call home. In one of the richest cities in the world, an estimated 2,200 public school students lack permanent homes.

Back in 2004, Newsom appointed former Supervisor Angela Alioto to head the council charged with crafting the plan to end chronic homelessness within a decade. On the ambitious plan's first page, Alioto expressed confidence it would work, writing, "I certainly look forward to this particular victory party!"

But a walk around the city finds little reason to celebrate.

10 years later

Lt. Gov. Newsom and a Chronicle reporter visited Civic Center Plaza, Mid-Market and the Tenderloin to see whether the streets had changed in 10 years.

Newsom, 46, now lives in Marin County, but to San Francisco's homeless people, he's still instantly recognizable and beloved. People shouted his name, stopped him for cell phone photos and said he should run for president.

That was the same year Newsom joined the Board of Supervisors, where he developed a keen interest in homelessness. In 2002, he championed the Care Not Cash program to slash county welfare checks in exchange for housing and spearheaded the 2003 ban on aggressive panhandling, which banned begging near ATMs or on public transportation and prohibited repeated solicitations after a person declined to give money, following the person or blocking their passage.

In that November's election, he and then-Supervisor Matt Gonzalez emerged as the top two candidates in the first round of the mayor's race. Alioto had also run, and Newsom visited her law firm armed with a dozen red roses to ask for her endorsement in the December runoff.

Newsom installed Alioto as the leader of a 33-member panel given four months to craft the city's Ten Year Plan to Abolish Chronic Homelessness. Perhaps surprisingly, the plan was encouraged by then-President George W. Bush's administration, which had focused on ending chronic homelessness and tied federal grants to the writing of 10-year plans.

The majority of those who worked on San Francisco's plan or provide homeless services today say the plan's primary goal of building 3,000 supportive housing units by 2010 was spot-on. The city is still 300 units shy of making that goal, but is set to reach 3,106 units by the end of next year.

Last year's count, the most recent, found 6,436 homeless people. Of those, 1,977 people were chronically homeless. The total number hasn't budged much since a drop of about 2,000 people between 2002 and 2005, a plunge Newsom said was due to his Care Not Cash program and Ten Year Plan, but that homeless advocates said was simply inaccurate.

Now, Newsom, the plan's biggest backer, believes homelessness can never be eradicated. You can house thousands of people, and for each of them, homelessness is over, he said. But for the city, it's not.

"There's a mythology that you can - quote unquote - end homelessness at any moment, but there are new people coming in, suffering through the cycles of their lives," he said. "It's the manifestation of complete, abject failure as a society. We'll never solve this at City Hall."

Housing-first strategy

For Alioto, the plan's most important words were "permanent, supportive housing." Before, city service providers tried to address homeless people's underlying problems - such as alcoholism, drug abuse or mental illness - while they were still living on the streets.

The Ten Year Plan shifted that strategy to get people inside as quickly as possible and provide on-site case managers to help them work through all those other issues without having to worry about where they'd sleep that night. Tied to that was eliminating emergency shelter beds, replacing them with 24-hour crisis clinics and sobering centers.

"I hate shelters," Alioto said. "If you want to abolish homelessness, you've got to abolish the programs that support it."

In the spring of 2004, it was estimated by the authors of the plan that the city had 3,000 chronically homeless people - defined by the federal government as living somewhere not meant for human habitation for more than a year or having four or more periods of homelessness over three years.

Each of them was estimated to cost the city $61,000 a year in emergency room services or incarceration, but that could be reduced significantly if they were living inside - at a cost, with the housing and social services combined, of just $16,000 annually. Getting the chronically homeless off the streets would free up city money and time to serve less needy homeless people, the plan's authors believed.

In some ways, the plan worked. In the past 10 years, 11,362 homeless single adults have been housed. An additional 8,086 people have been sent home to a willing friend or family member through the Homeward Bound program, which pays for bus tickets out of San Francisco and back to their hometowns.

Alioto maintains that the plan is "not flawed" and that it was going great for about five years. Then the jolting economy and change in mayoral leadership meant the plan was essentially shelved, she said.

Newsom stationed his homeless czar across the hall from his second-floor office and constantly met and texted with him. Lee moved his homeless czar to the basement and hardly ever meets with him.

"Gavin was very attentive to homelessness," Alioto said. "You have a new administration who's not as attentive. It's not the issue he wants to deal with as mayor."

Changing leadership

Lee came to office as the appointed replacement for Newsom, without an agenda vetted at the polls. The onetime head of the Department of Public Works has focused on the homeless - if at all - with an eye to clearing them from mid-Market Street and surrounding alleys so those areas, now home to major tech companies, can be cleaned each morning.

Earlier this year, Lee gave himself a C on tackling homelessness. But in an interview, he disputed Alioto's assertion that he isn't emphasizing homelessness as much as Newsom did.

"I don't think there's been a de-emphasis at all," he said. "I haven't let go, and I don't think this administration has let go of the fact that permanent housing with supportive services on the side is still the answer. We're still going in that direction."

He said San Francisco's homeless problem would be far worse post recession if his administration had not been focused on it. He said the most recent homeless count's findings that 39 percent were homeless somewhere else before coming to San Francisco points to the fact that the city attracts those seeking new opportunities - from the wealthiest tech titans to those most down on their luck.

"We're not closing our borders," he said.

The city spends $165 million a year on homeless services, about half of which funds supportive housing. That's one of the highest levels of per-capita spending on homelessness of any city in the nation, said Philip Mangano, who served as the nation's homeless czar under President Bush.

Lee and members of his administration can point to some wins. The percentage of the jail population that is homeless has been cut in half, signaling that the city is focusing on treatment rather than incarceration for homeless people. And veteran homelessness could be eliminated by next year, said Bevan Dufty, the mayor's point man on homelessness, which is not only good news for the veterans themselves but also proves that individual populations of homeless people can be focused on and virtually eliminated.

Lee's proposed budget for the next two years includes an additional $29 million for homeless services, including eviction prevention, mental health care and a new women's shelter that will be open in winter months.

But San Francisco can't end homelessness without much more support from the state and national governments, said Trent Rhorer, director of the city's Human Services Agency.

"The state budget that Gov. Brown put out does not mention homelessness once - he doesn't have any sort of agenda statewide for homelessness," he said. "And 25 percent of kids are in poverty now in California. That's what's frustrating."

Families left behind

Some of those children live in San Francisco - and ignoring them was a weakness of the Ten Year Plan.

Jennifer Friedenbach is director of the Coalition on Homelessness, which has Tenderloin offices covered in posters, like one reading, "How many people do you need to start a revolution?" In a recent interview there, she said the crux of the plan shouldn't have focused exclusively on single adults at the expense of families with children.

Her cell phone rang. It was Dufty, who had news that prompted a loud expletive from Friedenbach. The two thought they'd finally found housing for a homeless family with six children that lives in a van, but it fell through. One of the couple's children is developmentally disabled because she hasn't had space to learn to crawl or walk, a common problem for homeless children.

There are just 74 shelter spaces for families, and it's a six-month wait to secure one of them. Currently, about 200 families are on the waiting list, fewer than last year thanks to a new supportive housing complex for families that opened in the Bayview in the fall. But just 6 percent of the homeless housing planned for construction is intended for families, Friedenbach said.

It's easier for politicians to ignore homeless families because they're more likely to sleep unseen in cars, on the floors of friends' living rooms or elsewhere. Since they're hidden away, they don't pique voters' frustration.

Those families lucky enough to score a coveted rental subsidy from the city or from the San Francisco Housing Authority are increasingly having a hard time spending it in San Francisco because landlords can make so much more renting their units to big earners.

"It used to be that a homeless family came in and you could always get them a small unit in the Tenderloin they could afford," said Erica Kisch, executive director of Compass Family Services. "I can't even think of the last time we were able to house a family in the Tenderloin."

Shunning shelters

In addition to leaving out families, another flaw of the plan, critics say, was its call to eliminate shelters.

Officials and service providers have long disagreed over whether the city should run homeless shelters. The Ten Year Plan called for them to be eliminated. The number of shelter beds has been cut by a third - leaving nobody happy.

A decade ago, the city had 1,910 shelter beds, and now it has 1,145. It has half the drop-in centers for homeless people during the day than it did 10 years ago.

Rob Gitin, executive director of At the Crossroads, a nonprofit whose homeless outreach is geared toward youths, said just because housing is universally preferred doesn't mean people don't need emergency shelters at night and drop-in centers during the day.

"Everyone knows that preventive medicine is more cost effective than emergency medicine, but that doesn't mean that hospitals all around the country close their emergency rooms," he said.

Jackie Jenks is the director of Hospitality House, which opened in 1967 as a neighborhood center but began running a shelter 15 years later after President Ronald Reagan slashed funding for public housing and low-income housing vouchers, and the number of homeless people rose dramatically.

The center's clients who'd previously come to play chess, use the telephone or pick up mail had nowhere to go at night. So it allowed them to stay, 100 men sleeping wall to wall on mats in one of the city's first homeless shelters.

Now, about 30 people sleep there at night - in real beds - and roughly 500 more a day go to the nonprofit's two drop-in centers to use bathrooms, access a range of services or just get a break from the streets.

Jenks called it a "nice idea" to think people shouldn't sleep in shelters, but said it belies reality in a city where 6,436 people have nowhere to sleep at night.

Daytime disincentives

Just because the plan moved 3,000 people inside at night doesn't mean they're off the streets during the day.

The quality and amount of social services vary greatly between supportive housing complexes, and residents aren't required to take advantage of them. Many residents either languish in their tiny rooms all day or panhandle.

Some argue that the behavior on the streets is out of control and needs to be dealt with.

Bill McConnell worked in quality management for the behavioral health division of the city's Department of Public Health from 1975 to 2007. Essentially, he evaluated what worked and what didn't when it came to how the city handled mental health.

He said the Ten Year Plan focused intensely on positive incentives to get homeless people off the streets, such as outreach, supportive housing and Project Homeless Connect to provide a one-stop shop for homeless people to access services. But a better approach, he believes, would be to add disincentives into the mix.

Despite several laws on the books that Newsom promoted (and that have been blasted by homeless advocates as being mean-spirited), there's not much police enforcement of them. Newsom's voter-approved 2010 ban on sitting or lying on sidewalks isn't enforced much outside the Haight, for example.

More significantly, open-air drug dealing and drug use persist, public urination and defecation are widespread, and downright creepy behavior such as screaming at and threatening passersby is tolerated. The Ten Year Plan avoided much discussion of law enforcement.

"If you're very tolerant of inappropriate behavior, you're pretty likely to keep getting more of it," McConnell said. "When I thought of myself as a professional observer, it never seemed to change. And it seems to be getting worse."

Despite all these complaints, many of which Newsom agrees with, the former mayor remains glad he pushed for the plan because it united many disparate groups behind the idea that permanent housing is the right way.

"The plan was just setting expectations, setting standards and guiding principles," he said. "If you fail to plan, you're planning on failing."